[Delayed Cardiac Partial Herniation after Right-sided Pneumonectomy:Report of a Case]

Cardiac herniation is a rare complication after pulmonary surgery. A 59-year-old woman underwent right-sided pneumonectomy for right pulmonary squamous cell carcinoma, pulmonary vein was ligated intrapericardialy and the pericardial defect, which mesasured about 2 cm was not repaired. After four months, the patient complained of bilateral lower leg edema and dyspnea on effort. Computed tomography (CT) showed the right atrial herniation into the right-sided thoracic cavity. We diagnosed with symptomatic cardiac herniation and performed opration with small thoracotomy. At operation it was found that the right atrium herniated into the right-sided thoracic cavity. There were no adhesions between the pericardium and the right atrium. We placed the right atrium back within the pericardium and repaired using a bovine pericardial patch. The postoperative course was uneventful. Bilateral lower leg edema and cardiac herniation disappeared. Cardiac herniation did not recur over four years postoperatively.